Alcoholism Masks Elderly`s Problems

July 22, 1985|By Glenn Collins, The New York Times

New research findings suggest that alcoholism among the elderly is a more serious problem than previously believed.

A number of experts believe alcoholism has long been confused with the symptoms of other diseases among the aged. They see alcoholism as a hidden contributor to some of the most prevalent ailments of the elderly, including mental problems, broken bones from falls and other disabilities such as incontinence.

Researchers have found that not only does alcoholism have debilitating effects on the health of the elderly, but that it also can mask the symptoms of other serious illnesses.

The findings, about both the extent and the nature of problem drinking among the old, have led a variety of federal agencies to increase their efforts to study the problem.

The number of elderly problem drinkers is expected to rise as the nation`s aged population increases, even though the rate of alcoholism among the elderly is lower than in the general population.

``Even if the overall percentage of alcoholism in the elderly population is low, it`s a huge national problem,`` said Dr. Michael L. Freedman, director of the division of geriatric medicine at New York University Medical Center.

``Until relatively recently, many doctors had certain preconceptions about old people, and this led to misdiagnoses,`` he added. ``For example, in some patients, symptoms that were thought to be those of senility were actually being caused by alcoholism. I think we`re still underdiagnosing alcoholism among the elderly.``

Currently, studies of the scope, causes and effects of alcohol abuse by the aged are being conducted by the National Institute of Mental Health, the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Aging and the Veterans Administration.

``Those who are studying alcohol and the elderly are on the cutting edge of a relatively new field of research,`` said Dr. Ernestine Vanderveen, chief of the psychosocial research branch at the alcoholism institute. ``And we`re trying hard to stimulate research interest in this area.``

Vanderveen said that financing for such research was increasing. She added that she could not place a specific dollar cost on studies of alcoholism and aging, because such research is often part of broader studies involving alcoholism, the elderly and mental illness.

More than a million of the 28 million Americans older than 65 are believed to be problem drinkers, according to the National Council on Alcoholism, a non-profit educational organization. A 1982 study by Dr. Jacob Brody of the National Institute on Aging suggested that from 10 to 15 percent of elderly patients seeking medical help had a drinking problem related to their ailment.

Gathering accurate statistics has been complicated by conflicting definitions of alcoholism, as well as the difficulty of obtaining accurate survey information. However, an ongoing government study of mental illness, the most comprehensive ever done on psychiatric problems in the United States, is enabling researchers to estimate more precisely the numbers of elderly alcoholics in selected areas of the country.

Called the Epidemiologic Catchment Area program, the study is sponsored by the National Institute of Mental Health. So far, it has involved household interviews with subjects in New Haven, Baltimore, St. Louis and Durham, N.C.

The study suggests that alcohol abuse or dependence is a problem for 1.4 to 3.8 percent of the men older than 65 in the research sample, and from 0.1 to 0.7 percent of the women in that age group. Additional findings from interviews conducted in Los Angeles have not been analyzed. More than 20,000 people are to be interviewed.

``This is the most definitive study available of the prevalence rates of specific disorders,`` said Dr. Darrel A. Regier, director of the division of biometry and epidemiology of the mental health institute.

The institute`s interviewers defined alcoholism according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association. Subjects were diagnosed as abusing alcohol according to their scores in a variety of categories assessing their patterns of alcohol use, including whether they had a daily need to drink, whether they were unable to stop drinking, whether they went on drinking binges or suffered from blackouts, or whether they had missed work or been in accidents because of drinking.

``Until recently we`ve had very little in the way of accurate information about this population,`` said Dr. Nathan Rosenberg, the health scientist administrator at the alcoholism institute. He said research has drawn a distinction between two groups: those who begin drinking early in life, and those who begin late in life, often in response to loneliness or the death of loved ones.